Month: November 2014

The Myth of Core Stability

Today’s Thursday Throwback takes us back to 2010, when a controversial article questioning the benefits of “core stability” training was published. The post discusses what core stability really means, and the most effective progression we’ve found to not only minimize injury risk, but also to improve performance in athletic settings.

We still use variations of the exercises presented in the videos below. They’re incredibly challenging, which our guys really enjoy. Give them a shot the next time you’re in the gym with a partner.

Enjoy!

The Myth of Core Stability

Few people would argue that core training is an integral part of an athletic development training program. Aesthetic benefits aside, core training is widely accepted as improving:

Lumbar stability and therefore reducing risk and/or symptoms of low back pain
Force transfer between the lower and upper body, which improves power in just about every athletic movement (kicking a soccer ball, swinging a bat, lacrosse and hockey shooting, fighting off defenders in every contact sport)
Stability of the pelvis to allow for more efficient lower body movements, such as rapidly changing direction

Because of the core’s importance in both maximizing performance and minimizing injury risk, core stabilization concepts are one of the underlying foundations of all of our training programs at Endeavor. If you’ve been following my site for a while you know that I do my best to actively seek out new information to better design programs to help our athletes. Last week I came across a draft of an article from Eyal Lederman, a professor in London, titled “The Myth of Core Stability.” I’m always intrigued by articles that argue against the norm as these are usually the most eye opening.

Lederman argued that the evidence in support of core stability training to back pain is pretty limited. He notes that strength may not be the issue since some of the major core muscles are minimally active during activities of daily living. As a quick background, muscles become “active” when the body sends an electrical signal to the muscle to contract. For study purposes, the signal is often “normalized” to a maximal value for that muscle (MVC). When we talk about these “maximal” values, we need to keep in mind that maximum activation is highly dependent upon the length of the muscle and direction of the movement, but I won’t bore you with all the underlying neuroscience.

The article cites research demonstrating that walking necessitates average values of:

2% MVC from the rectus abdominis (the six pack muscle)
5% MVC from the external obliques

Further research is cited painting the picture that normal activities (even some with external loads added) require minimal trunk muscle activity (between 1-5% MVC).

The underlying tone of the article was that core stability training is foolish and scientifically unsupported. I bring up this article because many times these things work their way to your eyes and ears through the media with headlines like “Core Training Is Not Important” as some staff writer attempts to create an interesting story with out-of-context research. Within an athletic context, there are a few things worth keeping in mind:

The article cites trunk activity during walking and standing, not hockey-relevant movements like skating, changing directions, shooting, taking hits, etc.
The article is put within the frame of solving back pain, not optimizing performance
The article largely ignores evidence of active people with back pain resolving symptoms by putting a greater focus on improving their posture and core stability
Like many academics, this article systematically (although using flawed logic) dismisses many commonly held beliefs about core training, but fails to offer any alternative

At Endeavor Sports Performance, our core training system functions to integrate appropriate mobility and stability of the pelvis and spine into athletic movements. We follow a basic progression of:

Reinforce core stability in static positions (front planks, side planks, glute bridges, anti-rotation belly press isoholds, etc.)
Increase challenge to static core stability by adding a dynamic component (chop and lift variations, plank and bridge “marches”, rollouts, tight rotations, 2-Way Bunkie side planks, dynamic anti-rotation belly press’, etc.)
Maximize unexpected dynamic stiffness through perturbation training (Split stance belly press with perturbation, overhead stability ball perturbation, squat with overhead stability ball perturbation, split squat with overhead stability ball perturbation, stability ball front plank with perturbation, side plank with perturbation, etc.)

While I think most people are at least loosely familiar with the first two steps of this progression, few athletes have been exposed to perturbation training. I strongly believe this type of training will drastically increase in popularity over the next several years. Check out videos of a couple of the more advanced progressions of perturbation training below. Have you ever seen anything like this?

Split Squat IsoHold with Overhead Stability Ball Perturbation

Stability Ball Front Plank with Perturbation

Colby Cohen and Jeff Buvinow do a great demonstrating these exercises. The goal is to not move at all or, more realistically, to minimize the displacement and return to “neutral” as quickly as possible. It’s hard to tell from the video, but I’m really “cranking” on them pretty hard. We progress to more vigorous perturbations, but ultimately we want to challenge their stability in multiple directions. In the first video, I’m randomly alternating amongst pushing, pulling, and rotating the ball in a variety of directions. In the second video, I’m somewhat randomly alternating between rotating the hips, rotating the shoulder, and laterally deviating the hips and shoulders. By creating a random variety of stresses, the athlete learns to reflexively generate stiffness.

To your success,

Kevin Neeld
OptimizingMovement.com
UltimateHockeyTraining.com
HockeyTransformation.com

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Is your corrective approach leading to injury

When I was growing up playing hockey, at least once every season I’d have some sort of left groin or hip flexor issue.

None were ever significant enough to keep me off the ice, but they were always enough that I was constantly “aware of it”, which is not where you want your focus going while you’re playing.

I always wondered if there was something I was doing, or not doing, that was causing these injuries.

Now that I’ve made the transition from player to S&C coach, I’m thankful for my long list of injuries as they’ve motivated me to learn more about functional anatomy, biomechanics, and a number of other injury risk factors.

Naturally, one of the major goals of every program I write is to reduce my athletes’ risk of injury. As a result, it’s important to understand what factors may predispose an athlete to injuries in the first place, and then make decisions about what I have the ability to influence.

With the increasing popularity of PRI and FMS courses over the last several years, a lot of attention is being paid to the potential for faulty movement patterns to contribute to breakdown. This is obviously an area I subscribe to, as I’ve taken FMS Level 1&2, the SFMA course, and spent over 100 hours in PRI courses, in addition to becoming PRT-credentialed a couple years ago.

With that said, purely postural/biomechanical approaches to injury risk have been appropriately questioned in the research, as these are really just one piece of the puzzle. In an effort to perfect movement, coaches may be inadvertently increasing their athletes’ risk of injury.

Identifying Injury Risk Factors

The most effective approach to injury risk reduction is to attack it from all angles. While this topic can get pretty complex, I generally think of risk factors as falling into these major buckets:

Postural/Biomechanical: Determines length/tension relationships, how mechanical stress is distributed during movement, and movement efficiency in general
Neuromuscular Abilities: Force production, rate of force development, and timing of force production
Conditioning/Fitness: The ability to repeat the sport-specific movement demands at a consistently high level and recover appropriately, both in a short-term perspective following a work bout, and at the conclusion of a training session/practice/game
Stress Tolerance: The resiliency of the body to the accumulation of stressors from within and outside the training/sports paradigm. This also determines the individual’s adaptation capacity at any given period of time
Accumulated Fatigue: Related to stress tolerance; influences all of the above factors

Each of these areas is an important contributor to injury risk and needs to be considered in a training program.

When Corrective Exercise Goes Wrong

A couple years ago, I remember hearing people talk about how some personal trainers and strength coaches were taking some of these movement-based courses and basically not letting their clients/athletes do anything except corrective work until they met some standard. At the time, as I would now, I remember thinking “people actually do that?”

As time has gone by, I realize this is more common than I would have ever thought.

If you come back to the list above, focusing on movement capacity to the exclusion of other qualities will only improve that one injury risk factor. An argument can be made (that I’d agree with) that improving movement quality can improve stress tolerance by reducing unnecessary tension/tone resulting from a compensatory attempt to produce the desired movement, but not to the same degree that also addressing fitness/conditioning and accumulated fatigue would.

Probably the biggest oversight in an overly “corrective” approach is that the athletes actually detrain. Having slow, weak, and poorly conditioned athletes that move well doesn’t only neglect many key areas of injury prevention, it makes them worse at their sport.

A Better System

Even in the presence of movement limitations, athletes need to train to improve, or at least maintain, their performance capacities. The key here is to pick exercises and methods that are best suited for the athletes based on their current movement abilities. This is one of the major topics I discussed in in my DVD Optimizing Movement, as having a system for what to do in the presence of specific movement limitations makes it easy to individualize training, even in a group or team setting.

Assessing factors that influence movement, and demonstrating how to use them to drive your training approach

It’s important to recognize that slow, weak, poorly conditioned, stressed out, and/or tired athletes are all at a greater risk for injury. With this in mind, training programs should be designed to develop physical capacities using individual-specific exercises/methods while also improving notable movement limitations, with coaches monitoring stress and accumulated fatigue to make any necessary adjustments to training loads or recovery strategies on an ongoing basis.

Wrap Up

Looking back on my own injuries, I can remember that some happened when I just didn’t feel right (possibly an alignment issue), some were the result of overuse, and others were simply because I was too weak.

As strength and conditioning coaches, our job is to deliver highly trained, injury resistant athletes to our coaches. As more emphasis is placed on assessments and corrective work, it’s important to not lose site of the importance of continuing to develop the speed, power, strength, and conditioning of our athletes, while also monitoring fatigue. Ultimately, a more comprehensive approach will not only improve their durability, but also their performance.

To your success,

Kevin Neeld
OptimizingMovement.com
UltimateHockeyTraining.com

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Click here for more information >> Optimizing Movement

Massage School for Strength Coaches

I’ve always been a huge proponent of the benefits of getting quality manual work. When I first started at Endeavor, one of the first things I did was do a search for local practitioners that had a few specific skill sets and mailed out letters introducing myself.

This process, albeit a little awkward, was crucial to building a local referral network. I quickly realized two things, however, that were huge barriers to successfully using this referral network:

The “top” practitioners were ~30 minutes away from our facility
Because we had clients that were already driving 30 minutes to 2 hours each way to come train with us, many simply weren’t willing to drive another half hour (often times in the opposite direction) to go get manual work.

As a result, I considered going back to massage school so I could offer some of these same services at our facility. I basically sat on this idea for 2 years, until I finally took the plunge and enrolled at Lourdes Institute of Wholistic Studies in Collingswood, NJ (where I later moved).

I basically went back for three major reasons:

After studying anatomy consistently for ~8 years, I really felt that the next step for me to further internalize functional anatomy was to learn to differentially palpate different structures throughout the body. This was probably the biggest factor; it was an awesome opportunity to further my education and understanding of how we’re all built and how manipulating a structure can influence movement patterns.
As I mentioned above, it is an additional service we can offer at our facility and ultimately a way to improve the convenience for a great service that would benefit our clientele
I had talked to a few of my friends that work in or consult with pro sports teams and they said that having manual therapy skill sets opened the door for them working in these organizations.

For me, it wasn’t a huge time or financial commitment because I was basically able to test out of 1/3 of the curriculum.

With that said, I have no regrets about the decision and have since gone on to become Full Body ART Certified, in addition to taking Spina’s Functional Range Release course and a 3-part trigger point therapy course.

Outstanding education to accompany an effective treatment system

It seems to be a trend now that more strength and conditioning coaches are looking into massage school, as I get emails fairly regularly asking for advice on what I think about the process and whether or not it’s “worth it”.

Should you go to massage school?

It’s interesting to me that people ask me if they should go to massage school or not. The reality is I have no idea what you want to pursue as a career. I think people often look at education backwards. Before you make a decision either way, I’d encourage you to answer these questions:

What is my ideal career? In other words, what would I enjoy spending my time doing more than anything else? Picture the environment, clientele, typical work day, etc.
With your answer to #1 in mind, does anyone already have this job? If so, what skill sets do they have and how did they acquire them?
Use your responses to the above two questions to reverse engineer your path to your ideal career.

This may seem overly simplistic, but if you’re not passionate about manual therapy and don’t want to spend a significant portion of your day doing manual work on people, then it’d be a huge waste of money to go back to massage school.

Sure, being a licensed massage therapist can set you apart from other S&C coaches, but only if you actually use the skill set. If you hate doing it, you won’t use it. There are a lot of ways to distinguish yourself from other coaches; most notably, by getting better results.

Massage School does not Replace PT School

I think one of the major reasons many S&C coaches consider massage school is because they think, in conjunction with their training ability, that it’s a less expensive route to a physical therapy-like profession. This is an incredibly dangerous misnomer as massage therapists are neither credentialed, nor educated sufficiently, to replace a physical therapist. Among the countless examples of how different the education is between massage therapists and physical therapists, one of the most important is that massage therapists, even if they have good “treatment” skills, have almost no ability to diagnose sources of pain. This is true, regardless of how many SFMA, FMS, PRI, and other movement assessment courses you take, as there are a lot of sources of pain that aren’t just movement-based.

Simply, massage therapy and physical therapy are significantly different professions. If you want to be a PT, go to PT school.

Benefits of Massage School

Having said all of that, there are some benefits to going to massage school. Having a good set of manual therapy skills can help you:

Help facilitate recovery in your athletes by performing “flush” type massages and/or simply using massage as a stimulus to facilitate a parasympathetic shift in the athlete
Manually release aberrant tension in muscles/soft-tissue structures that may be causing restricted movement or undesirable postures in your clients
Work in conjunction with (not in replacement of) medical professionals to help facilitate client recovery from an injury

I think it’s a combination of all three of these points that makes the strength coach/massage therapist combo so attractive to teams, as it makes what is often a segregated “strength and conditioning staff” and “rehab staff” into a more cohesive “performance staff”.

That said, one of the things that I struggle with is finding time to do everything. With the Flyers Junior Team, I’m the Strength and Conditioning Coach, Manual Therapist, and am also responsible for data collection/player monitoring. This, of course, is on top of all of my other responsibilities for Endeavor, USA Hockey’s Women’s National Team, and running this site.

I mention this because I think it takes a pretty special work environment, which I have, to be able to balance the “strength coach” and “manual therapist” professions simultaneously. If I worked in a different environment, it may not be possible to do both. And with the increased responsibility of data analytics falling (appropriately so) on strength coaches, I think it will be even tougher for people to be exceptional as strength and conditioning coaches, while also being competent manual therapists. This is something I’d encourage you to consider very seriously before registering for massage school.

Wrap Up

In short, having the ability to offer manual therapy to your athletes can be extremely powerful in helping them stay healthy and recover fully. It can also allow you to work more effectively within a coordinated “performance team” that spans the sports medicine to sports performance continuum. That said, it’s not a fast-track replacement for PT school; the differences between the two need to be respected. Hopefully this sheds some light on my experience and provides some of the S&C coaches considering massage school some questions to think about before deciding one way or another.

To your success,

Kevin Neeld
OptimizingMovement.com
UltimateHockeyTraining.com

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“…one of the best DVDs I’ve ever watched”
“A must for anyone interested in coaching and performance!”